Head smart: the implementation of a law variation in community rugby union and its effect on head injury rates

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dc.contributor.advisorDerman, Wayneen_ZA
dc.contributor.advisorBrown, Jamesen_ZA
dc.contributor.advisorHendricks, Shariefen_ZA
dc.contributor.authorVan Tonder, Riaanen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medical and Health Sciences. Dept. of Exercise, Sport and Lifestyle Medication.en_ZA
dc.date.accessioned2024-01-22T12:56:36Z
dc.date.accessioned2024-04-26T23:54:53Z
dc.date.available2024-01-22T12:56:36Z
dc.date.available2024-04-26T23:54:53Z
dc.date.issued2024-03
dc.descriptionThesis (DPhil)--Stellenbosch University, 2024.en_ZA
dc.description.abstractENGLISH ABSTRACT: Background Concussion is a significant concern in contact and collision sports. Emerging evidence indicates potential negative long-term neurological and mental health outcomes associated with exposure to repetitive head impacts and concussion. Concussion is one of the commonest injuries in rugby union (‘rugby’) and most commonly occurs in the tackle. Thus, injury prevention strategies directed at the tackle require investigation. Objectives. The objective of this project was to investigate the implementation of a law variation trial in male amateur community rugby union and its effect on head injury rates, particularly concussion. The primary aim was to evaluate the effectiveness of lowering the maximum legal height of the tackle from shoulder- to armpit-level in reducing concussion incidence. Secondary aims were: 1) To characterise the tackle event and identify factors associated with illegal high tackles. 2) To investigate referee and player behaviour change as measures of successful implementation of the law variation. 3) To qualitatively explore stakeholder perceptions of the tackle law Methods.The study was conducted in Stellenbosch University's ‘Koshuisrugby’ League using a cross-sectional analytical design. Standardised epidemiological injury surveillance and return-to-play data were collected in years one and two of the study, and video footage of all matches in year 2. Covid-19 led to the cancellation of a planned third year of the study and thus no further injury or video surveillance occurred. Data were analysed to compare injury rates and severity between year 1 (2018; control year) and year 2 (2019; intervention year). Video footage was coded and analysed to characterise the tackle, identify factors associated with illegal high tackles, and investigate player and referee behaviour changes across one season. Individual, semi-structured stakeholder interviews were conducted to gain deeper understanding, through qualitative methods, of stakeholder perceptions of the effectiveness of the law variation and factors that influenced the law variation implementation. Results The incidence rate of concussion did not differ significantly between the control and intervention years (rate ratio: 0.69; 95% CI: 0.4 to 1.2; p=0.20). Overall, 108 matches were filmed and >14 000 tackles were coded and characterised. Factors associated with illegal high tackles were lower leagues, on tackles, arm tackles, upright tacklers, and ball carriers in low body positions. Promising positive player and referee behaviour changes were observed. Significantly fewer tacklers were upright in tackles in the last phase of the season and the sanctioning rate of illegal high tackles was significantly higher in the midphase of the season. Despite stakeholders valuing the law variation, many challenges remain to reduce concussion incidence. Ongoing educational campaigns are critical to address knowledge gaps and raise awareness. The prevailing culture in rugby, particularly in this cohort, pits performance against player welfare, mostly prioritising performance. This culture requires change. A multi-factorial, systems-based approach is needed to reduce concussion in rugby.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond Harsingskudding is 'n bekommernis in kontak- en botsingsport. Bewyse dui toenemend op potensiële negatiewe langtermyn neurologiese en geestesgesondheidsuitkomste wat verband hou met blootstelling aan herhaalde kopimpakte en harsingskudding. Harsingskudding is een van die algemeenste beserings in rugby unie (‘rugby’) en kom die meeste voor in die duikslag (‘tackle’). Dus, moet beseringsvoorkomingstrategieë gerig op die duikslag ondersoek word. Doelwitte Die doel van hierdie projek was om die implementering van 'n wetvariasieproef in manlike amateur rugby en die effek daarvan op hoofbeseringinsidensie, veral harsingskudding, te ondersoek. Die hoofdoel was om die doeltreffendheid van die verlaging van die maksimum wettige hoogte van die duikslag van skouer- tot okselvlak te evalueer om die insidensie van harsingskudding te verminder. Sekondêre doelwitte was: 1) Om die duikslag te karakteriseer en faktore te identifiseer wat verband hou met onwettige hoogvatte. 2) Om skeidsregter- en spelergedragsverandering te ondersoek as maatstawwe van suksesvolle implementering van die wetvariasie. 3) Om die persepsies van rolspelers t.o.v. die wetvariasie kwalitatief te ondersoek. Metodes Die studie is uitgevoer in die Universiteit Stellenbosch se ‘Koshuisrugby’-liga met 'n deursnee-analitiese ontwerp. Gestandaardiseerde epidemiologiese beserings- en terugkeer-na-spel-data is ingesamel in jaar een en twee van die studie, en videomateriaal van alle wedstryde in jaar 2. Covid-19 het gelei tot die kansellasie van die beplande derde jaar van die studie en dus kon geen verdere besering- of videodata verkry word nie. Data is ontleed om beseringskoerse en -graad (van erns) tussen jaar 1 (2018; kontrolejaar) en jaar 2 (2019; intervensiejaar) te vergelyk. Videomateriaal is gekodeer en ontleed om die duikslag te karakteriseer, faktore te identifiseer wat met onwettige hoogvatte geassosieer is, en speler- en skeidsregtergedragsveranderinge oor een seisoen te ondersoek.af_ZA
dc.description.versionDoctoralen_ZA
dc.format.extentxiv, 231 pages : illustrations
dc.identifier.urihttps://scholar.sun.ac.za/handle/10019.1/130611
dc.language.isoen
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subject.lcshRugby football injuriesen_ZA
dc.subject.lcshRugby League football -- Rulesen_ZA
dc.subject.lcshUniversity of Stellenbosch -- Sportsen_ZA
dc.subject.lcshCollege sports -- South Africa -- Stellenboschen_ZA
dc.subject.lcshRugby football -- South Africa -- Stellenboschen_ZA
dc.subject.lcshAmateurismen_ZA
dc.subject.lcshBrain -- Concussion -- Statisticsen_ZA
dc.subject.nameUCTD
dc.titleHead smart: the implementation of a law variation in community rugby union and its effect on head injury ratesen_ZA
dc.typeThesisen_ZA
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